Deborah A. Griffin - Troy 333 LLC 0-c6 Lt- v1-tgo
RECEIVED
Mr ;
:I ANI I B E1A2 H' Office of the City Clerk MAR _4 2022
1700 Convention Center Drive CITY OF MI.�MI BEACH
Miami Beach, FL 33139 OFFICE OF THE CITY CLERK
305.673.7411
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or
modification of any ordinance;resolution, action or decision of any commissioner; any action, decision, recommendation of the City
Manager or any City board or committee;or any action,decision or recommendation of any City personnel during the time period of the
entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the City
Commission, or a City board or committee. The term specifically includes the principal as well as any employee engaged in'lobbying
activities. The term "Lobbyist" has specific exclusions. Please refer to City Code Chapter 2, Article VII, Division 3, entitled "Lobbyists,"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City
Clerk. If you need more space to'complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular
section, you must write "none" or "n/a" in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
Griffin Deborah Ann
NAME OF LOBBYIST (Last) (First) (Middle Name)
Heritage Architectural Associates 4300 Biscayne Blvd, Suite 203 Miami FL 33137
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-761-3642 740-298-1061 dgriffin@heritagearchitectural.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Puig Louis
NAME OF PRINCIPAL (Last) (First) (Middle Name)
Troy 333 LLC 1251 Bella Vista Avenue Coral Gables, FL 33156
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-951-2839 305-951-2839 Iuislpuig@gmail.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Pursu 10 j node Se 0,2 482, i{ `, (DM? UV es so a on a a ne S }R.G'1' t 1'"'(A 'f n o _o o . 05 f�Ia..'IS' ]belief t Q
C %dtbt t s.-.a)o s se sa`0 Ce rermb rse e ttt as sea anca G^i Cb,{i . fG f'1 c17 contingent,to ca C s o o o rt(guano a sition
.eis stria .eo s o i ,t e 0ler,, -s red !red b t;is s bseetrae but she.l n t b- requtrsa a may -rov r-s striation ees
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY(if none,write N/A): Louis Puig
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): Louis Puig
Page 1 of 5
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
HPB21-0490 333, 337, 343 and 345 Jefferson Avenue
N/A
N/A
N/A
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship (If yes, explain) YES NO
Title of Person to be Lobbied
Historic Preservation Board N
N/A
N/A
N/A
N/A
N/A
Pursuant to City Code Section 2-482(g), every registrant shall be required to state the extent of any
business, financial, familial or professional relationship, or other relationship giving rise to an
appearance of an impropriety, with any current City Commissioner or City personnel who is sought to
be lobbied as identified on the lobbyist registration form filed.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
N/A
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
$200/hr
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The following six(6)questions MUST be answered:
1) Pursuant to City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues":
_Yes XNo: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or
pending award for goods,equipment or service?
2) Pursuant to City Code Section 2-490, entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues":
Yes XNo: Are you lobbying on a pending application for a Development Agreement with the City or application
—
for change of zoning map designation or change to the City's Future Land Use Map?
3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist" as set forth in
Section 2-481) who only appears as a representative of a not-for-profit corporation or entity without special compensation or
reimbursement for the appearance,whether direct or indirect to express support of or opposition to any item,shall register with
the city clerk as required by this section,but shall not be required to pay any registration fees.
YesXNo: Are you representing a not-for-profit corporation or entity without special compensation or
_ _
reimbursement?
4) Pursuant to City Code Section 2-481, the term "lobbyist' specifically excludes the following persons: Expert witnesses who
provide only scientific, technical or other specialized information or testimony in public meetings;any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,
indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance.
X Yes No: Are you providing only scientific, technical or other specialized information: appearing as a
representative of a neighborhood association without special compensation or reimbursement or
representing a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s) for whom the campaign consultant provided campaign consulting services
within the past election cycle.See Section 2-491 for more information.
YesXNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle? If yes,please list the incumbent member(s)of the City Commission:
_Yes_No: I yes. has it been less t an 12 months since the elected official(s) whom you provi o ed camel,n
consulting s
6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission at a public meeting.
YesXNo: Have you provided campaign consulting services to an incumbent member of the City Commission
— _
within the past election cycle?If yes.please list the incumbent member(s)of the City Commission:
Yes No: If yes, were you premised or did you recei. .e economic consideration in exchange for campaign
consulting services?
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee Yes( ,]No Amount Paid$ J % MGR# ��_U { Date Paid 0 1 Z Z.
Lobbyist Reglstratlon;Form received:and kverdied by. - �
FAcLERAsAt ito. i4sNkr Bet S'r rottior rl±ts.rzs i i t�ixgsry ti3O� o M. � r�tt r d a+. . •: Revis403/11.12020;
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION
RECEIVED. FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION�N DURING
��THE REPORTING PERIOD.'
Signature of Lobbyist: 0 L ` A�i G2i - Date 03/04/2022
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists"of
the Miami Beach City Code and all reporting requirements,
Signature of Lobbyist: •0' ' ' ' 4J "
- i , Date 03/04/2022
Signature of Principal: //I 7 I Date 03/04/2022
if '
/
VII. NOTARY SIGNATURE AND SEAL:
L s°lt":=YIST: PRINCIPAL
State of Texas State of Fl O ri
County of: Bell County of: Oacte..
Sworn to (or affirmed)and subscribed before me, Sworn to(or affirmed)and'subscribed before me,
by means of 0 physical presence by means of i'physical presence
or Eeonline notarization, or 0 online notarization,
this 4th day of March ,2022,by this jday of 1`AOIr_tA ,2022,by
Deborah A Griffin 1�ov i S -Pui ot
NAME OF LOBBYIST NAME OF PRINCIPAL
4. Produced ID Ohio Driver License Exp:04/01/2024 'O Produced ID FL D V. G"Q S0 (I f 1202 So
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
Personall Known _Personally Known
Signature of Notary Public Signature of ,.otary Public
RASHID RAUF es'c--e,\G. Ikka11S - sat/161c Z.
Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped
rhsiTh RABWDRAUF '"(NOTARY SEAL) (NOTARY SEAL) Dvw Notary Public State of Florida
aRtf i comas : Estela E.Marcos Sanchez
. ,".. • My Commission HH 084193
Notarized online using audio-video communication .?Qt As- Expires 01@4l2025
'The term"lobbyist"specifically excludes the following persons:
Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether
direct, indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
r. I
Cityof Miami Beach,1700 Convention.Center Drive,'.Miami Beach;Florida 33.139„wwwmiamibeachfl:gov
Office of the:City-Clerk
Rafael E. Granado,,,CityClerk; CityClerk@miamibeaclifl.gov
Tel: 305.673 741.T, Fax:305 673.7254'
NAME OF LOBBYIST: Deborah Ann Griffin
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements filed after the
due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and
Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the
assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 301" of each year, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
alataiU
3/3/2022
Signature of Lobbyist Date
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS1Lobbyist Registration Form Revised 03-11-20 REG.doc
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